Selecting a CAM Practitioner

Introduction

Selecting a health care practitioner -- of conventional1 or complementary and alternative medicine (CAM) -- is an important decision and can be key to ensuring that you are receiving the best health care. The National Center for Complementary and Alternative Medicine (NCCAM) has developed this fact sheet to answer frequently asked questions about selecting a CAM practitioner, such as issues to consider when making your decision and important questions to ask the practitioner you select.

1 Conventional medicine is medicine as practiced by holders of M.D. (medical doctor) or D.O. (doctor of osteopathy) degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses. Other terms for conventional medicine include allopathy; Western, mainstream, orthodox, and regular medicine; and biomedicine. Some conventional medical practitioners are also practitioners of CAM.

Key Points

If you are seeking a CAM practitioner, speak with your primary health care provider(s) regarding the therapy in which you are interested. Ask if they have a recommendation for the type of CAM practitioner you are seeking.

NCCAM does not provide CAM therapies or referrals to practitioners.

Make a list of CAM practitioners and gather information about each before making your first visit. Ask basic questions about their credentials and practice. Where did they receive their training? What licenses or certifications do they have? How much will the treatment cost?

Check with your insurer to see if the cost of therapy will be covered.

After you select a practitioner, make a list of questions to ask at your first visit. You may want to bring a friend or family member who can help you ask questions and note answers.

Come to the first visit prepared to answer questions about your health history, including injuries, surgeries, and major illnesses, as well as prescription medicines, vitamins, and other supplements you may take.

Assess your first visit and decide if the practitioner is right for you. Did you feel comfortable with the practitioner? Could the practitioner answer your questions? Did he respond to you in a way that satisfied you? Does the treatment plan seem reasonable and acceptable to you?

CAM is a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. Complementary medicine is used together with conventional medicine, and alternative medicine is used in place of conventional medicine. Some health care providers practice both CAM and conventional medicine. The list of what is considered to be CAM changes continually as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge. For more about these terms, see the NCCAM fact sheet "What Is CAM?"

2. I am interested in a CAM therapy that involves treatment from a practitioner. How do I go about finding a practitioner?

Before selecting a CAM therapy or practitioner, talk with your primary health care provider(s). Tell them about the therapy you are considering and ask any questions you may have. They may know about the therapy and be able to advise you on its safety, use, and effectiveness, or possible interactions with medications. Here are some suggestions for finding a practitioner:

Ask your doctor or other health professionals whether they have recommendations or are willing to make a referral.

Contact a nearby hospital or a medical school and ask if they maintain a list of area CAM practitioners or could make a recommendation. Some regional medical centers may have CAM centers or CAM practitioners on staff.

Ask if your therapy will be covered by insurance; for example, some insurers cover visits to a chiropractor. If the therapy will be covered, ask for a list of CAM practitioners who accept your insurance.

Contact a professional organization for the type of practitioner you are seeking. Often, professional organizations have standards of practice, provide referrals to practitioners, have publications explaining the therapy (or therapies) that their members provide, and may offer information on the type of training needed and whether practitioners of a therapy must be licensed or certified in your state. Professional organizations can be located by searching the Internet or directories in libraries (ask the librarian). One directory is the Directory of Information Resources Online (DIRLINE) compiled by the National Library of Medicine (dirline.nlm.nih.gov). It contains locations and descriptive information about a variety of health organizations, including CAM associations and organizations. You may find more than one member organization for some CAM professions; this may be because there are different "schools" of practice within the profession or for other reasons.

Many states have regulatory agencies or licensing boards for certain types of practitioners. They may be able to provide you with information regarding practitioners in your area. Your state, county, or city health department may be able to refer you to such agencies or boards. Licensing, accreditation, and regulatory laws for CAM practices are becoming more common to help ensure that practitioners are competent and provide quality services.

3. Will insurance cover the cost of a CAM practitioner?

Few CAM therapies are covered by insurance, and the amount of coverage offered varies depending on the insurer. Before agreeing to a treatment that a CAM practitioner suggests, you should check with your insurer to see if they will cover any portion of the therapy's cost. If insurance does cover a portion of the cost, you will want to ask if the practitioner accepts your insurance or participates in your insurer's network. Even with insurance, you may be responsible for a percentage of the cost of therapy.

4. I have located the names of several practitioners. How do I select one?

Begin by contacting the practitioners on your list and gathering information.

Ask what training or other qualifications the practitioners have. Ask about their education, additional training, licenses, and certifications. If you have contacted a professional organization, see if the practitioners' qualifications meet the standards for training and licensing for that profession.

Ask if it is possible to have a brief consultation in person or by phone with the practitioners. This will give you a chance to speak with them directly. The consultation may or may not involve a charge.

Ask if there are diseases/health conditions in which the practitioners specializes and how frequently they treats patients with problems similar to yours.

Ask if the practitioners believe the therapy can effectively address your complaint and if there is any scientific research supporting the treatment's use for your condition. (For information on how you can look for scientific information regarding a therapy, see our fact sheet "Are You Considering Using CAM?")

Ask how many patients the practitioners typically see in a day and how much time they spend with each patient.

Ask whether there is a brochure or Web site to tell you more about the practice.

Ask about charges and payment options. How much do treatments cost? If you have insurance, do the practitioners accept your insurance or participate in your insurer's network? Even with insurance, you may be responsible for a percentage of the cost.

Ask about the hours appointments are offered. How long is the wait for an appointment? Consider whether this will be convenient for your schedule.

Ask about office location. If you need a building with an elevator or a wheelchair ramp, ask about it.

Ask what will be involved in the first visit or assessment.

Observe how comfortable you feel during these first interactions.

Once you have gathered the information, assess the answers and determine which practitioner was best able to respond to your questions and best suits your needs.

5. I have selected a practitioner. What questions should I ask at my first visit?

The first visit is very important. Come prepared to answer questions about your health history, such as surgeries, injuries, and major illnesses, as well as prescriptions, vitamins, and other supplements you take. Not only will the practitioner wish to gather information from you, but you will want to ask questions, too. Write down ahead of time the questions you want to ask, or take a family member or friend with you to help you remember the questions and answers. Some people bring a tape recorder to record the appointment. (Ask the practitioner for permission to do this in advance.) Here are some questions you may want to ask:

What benefits can I expect from this therapy?

What are the risks associated with this therapy?

Do the benefits outweigh the risks for my disease or condition?

What side effects can be expected?

Will the therapy interfere with any of my daily activities?

How long will I need to undergo treatment? How often will my progress or plan of treatment be assessed?

Will I need to buy any equipment or supplies?

Do you have scientific articles or references about using the treatment for my condition?

Could the therapy interact with conventional treatments?

Are there any conditions for which this treatment should not be used?

6. How do I know if the practitioner I have selected is right for me?

After your first visit with a practitioner, evaluate the visit. Ask yourself:

Was the practitioner easy to talk to? Did the practitioner make me feel comfortable?

Was I comfortable asking questions? Did the practitioner appear willing to answer them, and were they answered to my satisfaction?

Was the practitioner open to how both CAM therapy and conventional medicine might work together for my benefit?

Did the practitioner get to know me and ask me about my condition?

Did the practitioner seem knowledgeable about my specific health condition?

Does the treatment recommended seem reasonable and acceptable to me?

Was the practitioner clear about the time and costs associated with treatment?

7. Can I change my mind about the treatment or the practitioner?

Yes, if you are not satisfied or comfortable, you can look for a different practitioner or stop treatment. However, as with any conventional treatment, talk with your practitioner before stopping to make sure that it is safe to simply stop treatment -- it may not be advisable to stop some therapies midway through a course of treatment.

Discuss with your practitioner the reasons you are not satisfied or comfortable with treatment. If you decide to stop a therapy or seek another practitioner, make sure that you share this information with any other health care practitioners you may have, as this will help them make decisions about your care. Communicating with your practitioner(s) can be key to ensuring the best possible health care.

8. Can I receive treatment or a referral to a practitioner from NCCAM?

NCCAM is the Federal Government's lead agency for scientific research on CAM. NCCAM's mission is to explore CAM healing practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals. NCCAM does not provide CAM therapies or referrals to practitioners.

9. Can I receive CAM treatment through a clinical trial?

NCCAM supports clinical trials (research studies in people) on CAM therapies. Clinical trials on CAM are taking place in many locations worldwide, and study participants are needed. To find out more about clinical trials on CAM, see the NCCAM fact sheet "About Clinical Trials and CAM." To find trials that are recruiting participants, go to the Web site nccam.nih.gov/clinicaltrials/. You can search this site by the type of therapy being studied or by disease or condition.

For More Information

NCCAM Clearinghouse
The NCCAM Clearinghouse provides information on CAM and NCCAM, including publications and searches of Federal databases of scientific and medical literature. Examples of publications include "Selecting a CAM Practitioner" and "Are You Considering Using CAM?" The Clearinghouse does not provide medical advice, treatment recommendations, or referrals to practitioners.

ClinicalTrials.gov is a database of information on federally and privately supported clinical trials (research studies in people) for a wide range of diseases and conditions. It is sponsored by the National Institutes of Health and the U.S. Food and Drug Administration.
Web site: clinicaltrials.gov

National Library of Medicine (NLM)
NLM is the world's largest medical library. Services include PubMed, which contains publication information and (in most cases) brief summaries of articles from scientific and medical journals. CAM on PubMed, developed jointly by NCCAM and NLM, is a subset of the PubMed system and focuses on the topic of CAM. NLM also maintains DIRLINE a database that contains locations and descriptive information about a variety of health organizations, including CAM associations and organizations.

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